Loan Payment

Priority First FCU Electronic Loan Payment

WITHDRAWAL OF FUNDS FROM THE FOLLOWING FINANCIAL INSTITUTION

Account Type for Withdrawal*

Withdrawal Type*

Payment Disclosure

By Clicking Submit below: I hereby authorize the initiation of a deduction from my account and for the financial institution whose routing number is listed above to debit such account at the frequency set forth above. The Credit Union reserves the right to revoke this service due to excessive returns or abuse of any kind. The authorization is to remain in full force and effect until the Credit Union has received written notification from me of its termination at least five (5) business days prior to the next scheduled payment at the address provided above, and has had a reasonable opportunity to act on it. I also understand it is my responsibility to provide and maintain the most up to date and accurate financial information shown above. I agree to hold the Credit Union harmless and defend it against all liability, claims, demands, losses, damages, costs and expenses, including reasonable attorney’s fees, which it may incur or suffer related to the payment of any money pursuant to this Agreement. All ACH Originations scheduled to occur on a weekend or holiday will be requested from the originating institution on the first business day following the scheduled transfer date. For example, if the payment is scheduled to occur on a Saturday, the payment will be processed on the following Monday, (assuming Monday is not a holiday on which the Federal Reserve is closed). I understand I will be notified if the debit amount needs to be adjusted, either to be increased or decreased. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the above-noted periodic transaction dates. I agree to an additional $28.00 charge for each attempt returned NSF, which will be initiated as a separate transaction from the authorized recurring payment. I understand that the Credit Union may resubmit the request if the financial institution returns the initial request. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I agree not to dispute this recurring billing with my bank so long as the transactions correspond to the terms indicated in this authorization form. I understand that these changes may alter the original terms of the loan disclosure, including but not limited to, finance charges, length of loan and maturity. I confirm that I am legally authorized to execute transactions on the account designated above.

I agree to the above